Dental Caries, Infection, Bacterial, Tooth, Deciduous
Conditions
Keywords
Anterior Primary Tetth, Infected canals, chlorhexidine, Sodium hypochlorite
Brief summary
The process of removing bacteria and their products from the root canals is an essential step that is achieved through the combination of mechanical preparation and irrigation with chemicals. However, mechanical preparation alone can not reduce the microbial formations inside root canals, so at least about 35% of the root canal walls remain without the preparation tools reaching them. Many irrigants were used to irrigate the root canals, as sodium hypochlorite and chlorhexidine are the most famous. Although most studies have proven the effectiveness of sodium hypochlorite with its different concentrations in accomplishing this task, some of them showed the inability of the irrigant fluid to eliminate Enterococcus faecalis inside the canals. These bacteria are highly resistant, and therefore endodontic treatment fails in the long term.
Detailed description
Bacteria and their products play an essential role in the initiation and persistence of endodontic diseases. Therefore, eliminating them and preventing the return of their effectiveness is the desired goal in any successful endodontic treatment in the short and long term. Due to the fact that mechanical preparation of the root canal alone is not capable of removing the entire bacterial content, chemical irrigants were considered necessary to reduce the number of bacteria and toxins resulting from them. Until now, there is no irrigant capable of removing the entire bacterial content from the root canal. Despite the many advantages of sodium hypochlorite, several studies have revealed the toxicity of the solution in high concentrations of it, and it tends to cause tissue irritation when it comes into contact with the apical tissues. Chlorhexidine has been used for a long time in dentistry due to its antibacterial properties, long period of effect, and relatively low toxicity. This has prompted its use as an irrigant and an intra-canal dressing in endodontic treatment.
Interventions
* Irrigate the root canal with 1 ml of 2% CHx solution between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle. * Irrigate the root canal with 3 ml of the solution after using the last file. * Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine solution. * Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear. * Follow-up of endodontic treatment procedures for the treated tooth.
OTHERActivated chlorhexidine solution
* Irrigate the root canal with 1 ml of 2% CHx solution between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle with activation using an ultrasonic irrigation head. * Irrigate the root canal with 3 ml of the solution after using the last file with activation using an ultrasonic irrigation head. * Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine solution. * Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear. * Follow-up of endodontic treatment procedures for the treated tooth.
OTHERChlorhexidine gel
* Irrigate the root canal with 1 ml of 2% CHx gel between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle. * Irrigate the root canal with 3 ml of the gel after using the last file. * Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine gel. * Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear. * Follow-up of endodontic treatment procedures for the treated tooth.
OTHERActivated chlorhexidine gel
* Irrigate the root canal with 1 ml of 2% CHx gel between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle with activation using an ultrasonic irrigation head. * Irrigate the root canal with 3 ml of the gel after using the last file with activation using an ultrasonic irrigation head. * Irrigation with 3 ml of 0.5% Tween 80 and 0.07 % lecithin to remove residual chlorhexidine gel. * Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear. * Follow-up of endodontic treatment procedures for the treated tooth.
* Irrigate the root canal with 1 ml of 5.25% sodium hypochlorite solution between each file 1 mm from the apical foramen by using a 27-gauge irrigation needle. * Irrigate the root canal with 3 ml of the solution after using the last file. * Irrigating the canal with 3 ml of 5% sodium thiosulfate solution to remove residual of sodium hypochlorite. * Drying the canal with paper points (placing a 20 size paper point for 60 seconds in each canal) to take the bacterial smear. * Follow-up of endodontic treatment procedures for the treated tooth.
Sponsors
Damascus University
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
4 Years to 9 Years
Healthy volunteers
No
Inclusion criteria
1. Definitely positive or positive ratings of Frank scale. 2. Physiological root resorption no more than the apical third 3. Symptoms or signs of pulpal necrosis with or without radial lesions (swelling - fistua - abnormal movement). 4. At least 2 mm of bone surrounding the permanent bud. 5. Children who have not taken antibiotics in the past 3 months.
Exclusion criteria
1. Systematic or mental disorders. 2. Definitely negative or negative ratings of Frankel scale 3. Existence external or internal abnormal absorption.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Logarithmic reduction of bacterial count within the root canal of chlorhexidine solution. | 24 hours after sample incubation | Set the Petri dish on a grid background and count the colonies in each grid cell, moving in a methodical pattern through all of the cells. |
| Logarithmic reduction of bacterial count within the root canal of activated chlorhexidine solution. | 24 hours after sample incubation | Set the Petri dish on a grid background and count the colonies in each grid cell, moving in a methodical pattern through all of the cells. |
| Logarithmic reduction of bacterial count within the root canal of chlorhexidine gel. | 24 hours after sample incubation | Set the Petri dish on a grid background and count the colonies in each grid cell, moving in a methodical pattern through all of the cells. |
| Logarithmic reduction of bacterial count within the root canal of activated chlorhexidine gel. | 24 hours after sample incubation | Set the Petri dish on a grid background and count the colonies in each grid cell, moving in a methodical pattern through all of the cells. |
| Logarithmic reduction of bacterial count within the root canal of sodium hypochlorite solution. | 24 hours after sample incubation | Set the Petri dish on a grid background and count the colonies in each grid cell, moving in a methodical pattern through all of the cells. |
Countries
Syria
Outcome results
None listed